Most Relevant Information
Provider Data
| NPI Number: | 1003249368 |
| Provider Name: | LOTIS GAY PERILLA EDANO APRN, NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN001551 |
Most Important Dates
| Enumeration Date: | 08/09/2013 |
| Last Updated: | 03/23/2021 |
Provider Practice Location
2545 S BRUCE ST STE 200
LAS VEGAS
NV
891691778
Practice Location Phone/Fax
| Phone: | 7027322438 |
| Fax: | 7027337876 |
Provider Mailing Location
2545 S BRUCE ST STE 200
LAS VEGAS
NV
891691778
Provider Mailing Phone/Fax
| Phone: | 7027322438 |
| Fax: |